Pennsylvania threatens to sue Highmark over Medicare Advantage plan

The Pennsylvania Insurance Department, Attorney General and Department of Health have sent a letter to Highmark pledging to take legal action against the health insurer over its new zero premium Medicare Advantage plan, according to a Pittsburgh Business Times report.

The Medicare Advantage plan's network does not include Pittsburgh-based UPMC hospitals and physicians, which is a violation of the consent decree UPMC and Highmark reached in July, according to the report.

The threatened legal action is the latest development in a longstanding dispute between Highmark and UPMC, dating back to 2011, when Highmark announced it would acquire bankrupt West Penn Allegheny Health System in Pittsburgh — one of UPMC's largest competitors — in an attempt to maintain the viability of a lower-cost competitor to UPMC.

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